Why Do I Need to Do That?

Exam instructions help ensure highest-quality images.

Diagnostic imaging is an integral part of health care. It helps to uncover new disorders and follow the course of existing diseases. High-quality images enhance patient-physician decision making and can reduce unnecessary medical procedures. Stock photo from istockphoto.com.
When imaging is performed properly, it can help improve patient outcomes. When it’s poorly done, it can lead to unnecessary surgery and expense, as well as injury to the patient. For these reasons, LAD imaging in Deltona encourages people to be discerning when choosing an imaging center for their diagnostic studies.
“Several factors are important when selecting an imaging center,” confirms Barbara Borden, RT, interim center director. “We use state-of-the-art equipment, employ skilled technologists and radiologists and observe high standards of patient care. These are all important elements when patients are determining which imaging center can best meet their needs.”
Many choose LAD imaging because it is fully accredited and serves its community with a wide range of imaging tests. These include digital x-rays, computed tomography (CT), high-field MRI and magnetic resonance angiography (MRA), ultrasound (including four-dimensional OB images), vascular studies, echocardiograms, bone density testing and digital mammography.
“LAD imaging has been serving the community for more than forty years, and our staff has established relationships with our patients,” says Barbara. “The center is American College of Radiology accredited [ACR.org] for all the modalities they accredit. That includes MRI, CT, ultrasound and mammography.”
As an independent imaging center, LAD imaging has only one mission: to acquire high-quality diagnostic images with accurate interpretations so doctors have the best diagnostic information available when designing a treatment plan. With certain exams at LAD imaging, patients are given specific instructions to follow prior to testing. These requirements help ensure the clearest, most useful images possible.
“When patients follow the instructions before they come in, we get the best results from the exams,” states Barbara. “The technologists are able to see everything they need to see to get the highest-quality images. The radiologists then get the most information to write the most complete reports for the ordering physicians.”

Applicable Protocols

Mammograms are among the imaging tests with specific instructions. Patients getting these exams are told not to wear deodorant, powder or lotion under their arms or on their chests.
“Mammography film is very sensitive, which it needs to be to pick up the small suspicious areas that could be cancer,” explains Barbara. “Deodorants, powders and lotions can show up as little specs or calcifications on the mammography film and create false positive results.”
“The aluminum powder in deodorant resembles calcifications, which create artifacts on the images,” verifies Alfredo Hurtado, MD, a radiologist at LAD imaging. “The films become more difficult to read accurately when there are normal calcifications within the breast itself and added artifacts on top of the skin that also look like calcifications.
“As a result, patients may end up getting additional, unnecessary imaging to confirm results, which can cause needless worry for the patients. These things can easily be avoided by not having deodorant on.”
Pelvic ultrasound, which is used to image organs such as the kidneys and gallbladder, is another exam with instructions. Before getting this test, patients are asked to not eat anything after midnight the night before the exam is scheduled.
“When people eat, it stimulates these organs to start working, making it more difficult to visualize the anatomy,” describes Barbara. “Eating causes gasses to form in the digestive tract, and the ultrasound waves don’t penetrate these gasses very well, which interferes with the images.”
“With some pelvic ultrasounds, we ask the patients to have full bladders,” adds Dr. Hurtado. “A full, or distended, bladder displaces the bowel and gives us a window to look at the structures in the pelvis. When the bladder is empty, or flat, it’s harder to visualize these structures, and we cannot see as much detail.”
There are additional tests that have instructions, including CT exams when contrast dye is used. In these cases, patients are asked not to eat or drink for four hours prior to the test. This way, the digestive system is relatively empty, and the contrast will show up more clearly in the organs.
Patients scheduled for bone density testing are asked to refrain from taking calcium supplements for 24 hours before the exam. Pills that haven’t totally dissolved can interfere with the images, causing postponement of the tests.
“For the best results of any exam, patients need to follow the applicable protocols,” reiterates Barbara. “If they don’t, exams are delayed, which prevents their doctors from making quick diagnoses and scheduling appropriate treatment.”

Balancing Act

In modern medicine, doctors depend on imaging to help them diagnose diseases and conditions. Images allow them to “see” the sources of symptoms and better determine the treatments to alleviate them. It’s up to these same physicians to protect their patients from excess radiation exposure by using imaging judiciously.
“People accumulate radiation exposure over a lifetime,” notes Dr. Hurtado. “A person can get small doses over a long period of time. In the end, it’s not a large amount, so there’s a low risk to the patient. Or, a patient can get a very high dose in one shot, which may be the same amount as it took someone else ten or twenty years to accumulate. But in a single dose, that could be detrimental for that individual.”
Different imaging exams use different levels of radiation. Dr. Hurtado points to chest x-rays as an example of a common exam that uses a low dose of radiation but still provides excellent images.

“When patients follow the instructions before they come in, we get the best results from the exams.” – Barbara

“In this case, radiologists have gotten better over a hundred years,” he observes. “Unfortunately, we can’t remove the radiation, or the risk, one hundred percent, so we always have to be cautious in ordering the test. We must find the balance between benefits and risks. These factors must be discussed by the doctor and patient, and together they should decide what makes the most sense.”
Dr. Hurtado explains that great images are possible at a cost of high exposure, but that is both inconvenient and risky. Staff at LAD imaging work to maximize convenience and time of acquisition to get a clear image with minimal exposure.
“We use small doses of radiation to get our images,” stresses Dr. Hurtado. “It’s important for patients to ask their imaging center if they follow ALARA principles, which include the practice of using as low a radiation dose as possible to get quality images for the suspected diagnosis. There is a balance between quality and safety, and that’s what we strive for at LAD imaging. We use imaging wisely!”

Print This Article
    • LAD imaging

      For more than 35 years, LAD imaging has been providing leading edge diagnostic imaging services to the West Volusia area. Patient comfort, image quality and convenience are what they strive to deliver to their patients and referring ph... Read More

    • Alfredo Hurtado, M.D.

      Alfredo Hurtado, M.D. is Board Certified by the American Board of Radiology and is Fellowship trained in Musculoskeletal Radiology. He completed his undergraduate studies at George Mason University in Fairfax, Virginia and earned his medic... Read More

    • Henry Nguyen, M.D.

      Henry Nguyen, MD is Board Certified by the American Board of Radiology and the American Board of Nuclear Medicine. He completed his undergraduate studies at Rollins College in Winter Park, Fl and graduated from the University of Miami, School o... Read More